While everyone naturally hopes for a successful pregnancy and healthy baby, about one in five pregnancies will end in a miscarriage. How do you know if that’s happening to you? Here are some of the signs:

1. Pregnancy symptoms disappear

Most miscarriages happen a week or two after the pregnancy has already ended. Often the first symptom you notice is that you no longer feel nauseous and your breasts are no longer tender. You don’t “feel” pregnant anymore. Before you panic, though, remember that nausea and breast tenderness do normally decrease after about 12 weeks of pregnancy, so in most cases this is normal.

2. Vaginal bleeding

Between one in three and one in four women have some vaginal bleeding while pregnant, but only a small percentage will actually miscarry. It’s possible to have significant blood loss, with large clots, and still have the pregnancy continue. But if you are going to miscarry, bleeding tends to be an early sign. The bleeding that happens before a miscarriage may be light or heavy and may stop and start. If you are actually going to lose the baby, though, at some point it will become increasingly heavy.

3. Backache

Backache is, of course, a common pregnancy symptom, but if it is persistent and not related to your activity (you feel while resting in bed, for example) it can be a sign that your uterus is contracting and you are about to have a miscarriage.

4. Cramps/contractions

While mild Braxton-Hicks contractions are common throughout pregnancy, the contractions that precede a miscarriage are sharper, stronger and more painful.

All these symptoms can be present in a normal, healthy pregnancy, too, so don’t let them worry you. There is nothing you can do to prevent a miscarriage – as mentioned above, in most cases the baby has died at least a week or two before the other symptoms are noticed. If you have these symptoms, especially the vaginal bleeding and cramps, contact your doctor. An ultrasound will quickly confirm whether or not the pregnancy is going to continue.